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TCAs are one of the oldest of antidepressants and still prescribed widely. Before the introduction of selective serotonon reuptake, TCAs were the standard treatment for depression. They are effective and have the advantage of extensive experience accumulated over several decaded of use.

Within the brain, there are many naturally occuring chemical messengers called neurotransmitters. These chemicals are involved in controlling or regulating bodily functions. Two of these chemicals, noradrenal nad serotonin are involved in the control and regulation of mood which fluctuates in depression. When depression occurs, there may be a decreased amount of these two chemicals released from nerve cells in the brain. When these chemicals are released from nerve cells thet act to lighten mood. When they are reabsorbed into the nerve cells, they no longer have an effect on mood.

TCAs work by preventing this re-absorption of noradrenaline and serotonin back into the nerve cells. This prolongs the mood-lightening effect and in this way helps to treat depression.

The choice of TCA depends on a number of factors It should not be used if you have a heart problem, are breastfeeding, pregnant or have a liver Currently problem. Currently available TCAs are listed below –

Selective serotonin reuptake inhibitors (SSRIs)

Serotonin is one of the several chemicals called neurotransmitters that pass messages between nerve cells that are involved in depression. Each nerve cell generally uses one of these chemical to pass on messages to adjacent nerve cells. The nerve cells normally recycle serotonon by soaking it back up again. The SSRIs work by stopping this reutake of serotonin. As serotonin is not soaked up again, more will be present to pass on messages There are a number of SSRIs frequently used to treat depression. to nerve cells nearby.

Monoamine oxidase inhibitors (MAOI)

MAOI are one of the oldest classes of antidepressants and are typically used when other antidepressants have not been effective. They are used less frequently because they often interact with certain foods and requirfe strict dietary restrictions. MAOI can also result in severe adverse reactions if taken with many other medicines, including some over-the-counter cough and cold remedies. MAOI are mostly used for atypical depression.